Monday, March 28, 2005

"There are Sox fans (like myself), and there are Cub fans (for no apparent reason). A Sox fan hates the Cubs. A real Cub fan (and there are some of these around) hates the Sox but not as vehemently as the Sox fan hates the Cubs. The `bandwagon' Cub fan (and there are lots of these) doesn't really care about the Sox (or doesn't even know they exist)."

I really don't care about the Sox and have nothing against their fans; I'm too busy hating the Cardinals and their a-hole fans to have much hate left for the South Siders.

(from Romenesko)Conservative Milwaukee Journal-Sentinel columnist Patrick McIlheran writes: "The blogosphere and National Review are dandy, but ultimately they repackage news, notoriginate it. If conservatives want news they can believe, they mustinvolve themselves in the daily reporting, photographing, editing,headlining and producing of news as eagerly as do liberals. Honestly, it'snot a hard field to get into. It's fun, and you'll find there are otherconservatives, too (as well as a lot of reasonably friendly liberals)."

Yeah, he's right that it's fun, and not usually hard to get into (depending on your circumstances) but he skipped over the fact that you have to be willing to make less money than a new teacher does.

There are countless Terri Schiavos across the nation, and the same difficult issues are being grappled with every single day.

I have witnessed many of these heart-wrenching situations as a pulmonary/critical care physician, and it has profoundly affected my thinking about end-of-life issues.

As a physician in the 21st Century, I have witnessed medical technology advance to such a degree that diseases that once killed can now be cured with little effort or at least treated successfully.

HIV is one. When I was a young lad in medical school, I would rarely see a patient with HIV over 30, and frequently they came into the hospital deathly ill. Now, however, I am routinely consulted on patients with HIV well into their 50s who have more "routine" medical illnesses.

Yet for all the advancement in medical technology, I have also seen a person be stricken with a disease that simply does not respond to treatment. Sometimes, in fact, the treatments administered can do much more harm than good. Mind you, this is not malpractice--it's just reality.

The most difficult cases for me, however, are the patients who, while surviving the disease's initial onslaught, are left with permanent organ damage, the most serious of which is the brain and nervous system.

Frequently, they are left neither fully alive nor fully dead.

This is where the difficult questions arise: Do we continue to "do everything," or do we "let nature take its course"?

The answers are not easy.

Continuing to "do everything" may come at a high price and with pain when subjecting the patient to complications of medical procedures and side effects of medications. Allowing "nature to take its course," on the other hand, can be an equally heart-wrenching decision, with feelings of guilt and remorse for relatives who perceive that they have "given up" on their loved one.

Yet these very difficult questions must be answered by every single one of us--here and now--when we are of sound mind, if not body. I cannot tell you how horrible a situation it is when a doctor approaches frightened and terrified family members--watching their loved one be in extremis--and ask them, "Should we do everything?"

Quite often, the family says, "do everything, doctor."

Yet that either may not be the most medically appropriate choice, such as in a patient with a terminal condition, or may not be what the patient truly wanted for himself or herself.

I have made my decision already: If there is no hope for my meaningful recovery, then I do not want my life sustained; please, let me die in peace and dignity and return to my Creator.

But that is not a decision I should be making for my patients. Rather, it is a decision for every free-willed human being and--most important--one that should be clearly delineated to our doctors and loved ones.

When I bring up end-of-life issues with my patients, they frequently fidget uncomfortably. It is such an important issue to discuss, however, that a brief moment of uncomfortable silence in a doctor's office is well worth it.

Whatever the decision, it has to be made, and it should be made between oneself, one's god, and one's family.

Governors mansions, state legislatures, houses of Congress and Oval Offices should never have to get involved.

Friday, March 25, 2005

This is interesting on many levels. The coverage issue is intriguing; why doesn't anyone want to ask Dusty about racism? He's been prefectly willing to share his feelings on race before.

The second interesting issue: is Chicago so racist that a black manager can't make it? Chicago is pretty racist. There is no disputing that. But I've never known criticisms of Dusty to be unwarranted or seemingly racist in any way.

Friday, March 18, 2005

Have you been shopping for china or stoneware recently? I have. The trend is toward HUGE plates. Salad plates are the size of what I'd consider a dinner plate, and what passes for a dinner plate these days is the size of a serving platter. Bowls are deep, cavernous pits. Check out your local Pottery Barn, Crate and Barrell, etc., when you have a chance. These huge dinning pieces have the insidious effect of making you want to fill them up. It's the little things that are making people so big.

Yesterday I was tooling around the touristy part of San Francisco on my bike, from Fisherman's Wharf and Pier 39 to the Golden Gate Bridge visitors' center. I saw a fair number of tourists on rented bikes, but I also noticed a new trend: people are renting these little miniature roadster thingies called "Go-Cars." You can also rent a Segway and get around town on that. Just another example of laziness and the trend away from exercise as recreation.

Tuesday, March 15, 2005

This is a fascinating article from Outside Magazine (which contains consistently great writing). Basically, economists are finding that preserving wild spaces for recreation and air and water quality makes more economic sense than drilling, logging and mining in most cases.

Friday, March 11, 2005

Thanks to Peter for pointing this out. I blogged about it last month, but the link appears to be gone! Hmmm...

"I said I had made a mistake in quoting him without checking with him," Moyers told E&P today. "I should have done my homework."

How does this kind of stuff happen? When did reporters get so careless? As a reporter, I always double-checked stuff to the point of paranoia. Why do some of these people think it's ok to play fast and loose with the truth? I just don't get it.

One of my primary problems is that it seems like maybe iTunes is lame, at least when used in a Windows environment. But there are others that just seem like idiocy on Apple's part:

One of the default settings when you install the iPod software is for it to pull every song you have on iTunes onto the iPod! Since I had already dumped all my MP3s (about 18 gigs worth) into iTunes it took some random selection that would occupy the 6 gigs on my new iPod mini and started downloading it. It took me quite a while to figure out how to stop this, because there's no paper manual, and the CD was pretty much inaccessible because of the intense downloading procedure.

Next, there's the physical iPod itself, especially the glorius "clickwheel," which is made out by many to be God's gift to consumer electronics. Well, I found it to be totally unintuitive, and I'm not exactly a novice when it comes to pulling gadgets out of the box and messing with them until I figure them out, without looking at the directions. I have figured it out, but I just don't understand the hype.

Finally, I'm still having a problem with it that's greatly affecting my enjoyment of the thing and it's usability: I can't figure out how to use the "random" function within a playlist, only within the entire list of songs that are on the iPod. My friend, Linda, is also having this problem, according to her fiance. If anyone knows how to do this, and can explain it to me, I would be very grateful!

Wednesday, March 02, 2005

First, I went to this place called Erik's Deli Cafe. I went there specifically to get this one kind of sandwich, which has pastrami and cheese heated in a pita. First, they were out of pastrami. Lame, but no biggie, substitute ham and roast beef. I ask for "no sprouts." When the guy hands my order to the sandwich-making people, I ask again, "Did you get the no sprouts?" He says yeah. What do I get on my sandwich? Sprouts. You have to be retarded to actually want to eat sprouts. First, they look like sperm. Second, they harbor disease. Third, they offer no nutritional or taste value. As a result of this incident, I am never going to Erik's Deli Cafe ever again. In fact, I am going to endeavor to never order a sandwich from some place that puts sprouts on sandwiches ever again. Which is one reason I like Le Boulanger so much (even though I think the name is silly, so I just call it BOO-lang-er). Oh, and if you needed another reason not to go to Erik's, their bread bowls (which they claim are sourdough, but I'm skeptical) are atrocious compared to Boulanger's.

The other annoying thing that happened to me today was that I got my iPod Mini. This was far and away the most disappointing, aggravating consumer electronics experience I have ever had. More details in a future post...